Gossip about childhood hepatitis of unknown etiology. To put it simply, last night, another industry boss who was big enough and professional enough to match couldn’t sit still. He publicly sang the opposite of CDC/UKHSA on Twitter~
This is Professor Isabella Eckerle, a professor of clinical virology at the University of Geneva, and the leader of the Center for Emerging Virus Infectious Diseases at the University Hospital of Geneva.
Now, please enjoy Mr. Eckerle’s superb performance of tearing UKHSA and kicking CDC.
——Original text, please taste it first (refer to later, with translation):
Translated into Chinese:
My opinion as a clinical virologist regarding childhood hepatitis of unknown etiology is that the adenovirus infection hypothesis is problematic in many ways, and this hypothesis has a great impact on clinical treatment.
First of all, the relevant cases mentioned in the report have very low viral loads and under normal circumstances, viral acute hepatitis can definitely be detected in blood with extremely high viral loads.
For example, acute severe hepatitis caused by hepatitis A, B, and E has this feature (hepatitis C virus rarely causes acute liver damage). The same is true for hepatitis caused by other hepatotropic viruses, such as yellow fever virus hepatitis. There is no viral hepatitis with severe clinical manifestations and low viral load at the same time.
The current situation is that the liver biopsy of these sick children did not reveal adenovirus, and the blood PCR load was very low. Even in some sick children, only whole blood PCR can detect adenovirus positive, but plasma PCR is negative.
Here I repeat: If the virus has replicated in the liver, then it must be everywhere. Positive – plasma OK, serum OK, tissue biopsy OK.
What’s more surprising is that the positive samples of the above cases are not even enough for whole genome sequencing… From my experience in virological diagnosis in university hospitals for more than ten years, I have a very strong impression. In a small number of patients with systemic adenovirus infection (all with severe immunosuppression), the viral load is very high, easily enough for whole genome sequencing and for virus isolation and culture. Most of the few sick children who were successfully sequenced were infected with ADV41, and it is well known that F41 serotype adenovirus cause diarrhea and other intestinal diseases, and there was no record of ADV41 causing hepatitis before.
Without sequencing evidence, it’s hard for me to imagine that ADV41 would suddenly switch tropism and cause acute severe liver injury in immunocompetent children – never observed before This situation — and now, it’s happening all over the world simultaneously, and not all cases test positive for adenovirus.
It is now the case that no common direct pathogen can be detected in cases worldwide, and signs of autoimmune liver injury in the post-acute infection phase are increasingly evident. Therefore, an important choice in clinical treatment is faced: What is antiviral treatment? Or immunomodulatory therapy? The former is only effective when the virus is replicating in the liver
So it is important to quickly share the experience of those successful cases. We urgently need to know which treatments actually work. Because the condition of these sick children is very serious, and if it continues to worsen, only a few highly specialized medical institutions have the capacity to perform liver transplants… At the same time we have seen that there have been many deaths in the United States. Finally, it is necessary to understand the world Adenovirus epidemics elsewhere, such as in many parts of Europe, are experiencing adenovirus community outbreaks. In addition, the serotype of adenovirus needs to be determined, and the positive rate of PCR test of whole blood of healthy children needs to be investigated.
Please applaud Mr. Eckerle!
Finally, now there are both liver disease clinical leaders (Mr. Jalali, etc.), epidemiology leaders (Mr. Gurdasani, etc.), and virology leaders (Mr. Eckerle!) ……
I wonder how long the adenovirus infection hypothesis of CDC/UKHSA will last?
When will the next scapegoat (scapegoat) be arranged?
